Cardiovascular Physiology D

Pregunta	Respuesta
Where is lead 1 located	between right arm and left arm; the left arm is positive
where is lead 2 located	between the right arm and left leg; left leg is positive
where is lead 3 located	between the left arm and left leg; left leg being positive
ECG leads	they detect a change in electric potential between two points) and detect the electrical potential change in the frontal plane.
V1 location	Fourth intercostal space to the right of the sternum.
V2 location	Fourth intercostal space to the Left of the sternum.
V3 location	between V2 and V4; between fourth and fifth intercostal space
V4 location	Fifth intercostal space at midclavicular line
V5	Level with V4 at left anterior axillary line
V6	Level with V5 at left midaxillary line; Directly under the midpoint of the armpit
V1 and V2 detect	right ventricle
V3 and V4	Septum/ lateral left ventricle
V5 and V6	Anterior/lateral left ventricle
myocardial infarction	The blood supply to certain areas of the myocardium is obstructed. The muscle tissue at the center of the infarct dies off
Cause of Myocardial infarction associated with atherosclerosis	plaque builds up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells
Other causes for heart attack	Stress Male gender Diabetes Family history of coronary artery disease (genetic or hereditary factors) High blood pressure Smoking Unhealthy cholesterol levels, especially high LDL ("bad") cholesterol and low HDL ("good") cholesterol.Chronic kidney disease
Symptoms for Heart attack	chest pain lasting longer than 20 minutes Sweating Anxiety Cough Fainting Dizziness Nausea or vomiting Palpitations (feeling like your heart is beating too fast) Dyspnea
Pain from Heart attacks might feel like	A tight band around the chest Bad indigestion Something heavy sitting on your chest Squeezing or heavy pressure
How to diagnose myocardial infarction	1. history of chest pain > 20 min 2. Changes in ECG tracings 3. Rise/ Fall of serum cardiac biomarkers 4. If there is a high positive R, there is also a Larger negative Q waves, ST segment elevation or depression, or coronary intervention are diagnostic of MI.
What are the cardiac troponins which are released within 4–6 hours of an attack of MI and how long do they stay elevated for	T and I and remain elevated for up to 2 weeks
Management for heart attack	which requires immediate medical attention. Oxygen, aspirin, and nitroglycerin.
Endocarditis	inflammation of the inside lining of the heart chambers and heart valves (endocardium
Endocarditis is usually a result of	blood infection
What are some things that increase chances for developing endocarditis:	Artificial heart valves Congenital heart disease Heart valve problems History of rheumatic heart disease
symptoms	Abnormal urine colorChills (common)Excessive sweating (common)FatigueFever (common)Joint painMuscle aches and painsNight sweatsNail abnormalities (splinter hemorrhages under the nails)Paleness
How to test for myocarditis	Blood culture and sensitivity (to detect bacteria) Chest x-ray Complete blood count (may show mild anemia) Echocardiogram (ultrasound of the heart) Erythrocyte sedimentation rate (ESR) Transesophageal echocardiogram
Treatment for myocarditis	Long-term, high-dose antibiotic treatment is needed to get rid of the bacteria. Treatment is usually given for 4-6 weeks, depending on the specific type of bacteria. Blood tests will help your doctor choose the best antibiotic.Surgery may be needed to replace damage heart valves.
Mitral stenosis	heart valve disorder that involves the mitral valve
Stenosis	refers to a condition in which the valve does not open fully, restricting blood flow.
Causes for mitral stenosis	the valve area becomes smaller, less blood flows to the body. The upper heart chamber swells as pressure builds up. Blood may flow back into the lungs. Fluid then collects in the lung tissue (pulmonary edema), making it hard to breathe.
Symptoms for mitral stenosis	Atrial fibrillation -Chest discomfort (rare): Increases with activity, decreases with rest -Radiates to the arm, neck, jaw, or other areas Tight, crushing, pressure, -Cough, possibly bloody (hemoptysis) Difficulty breathing during or after exercise or when lying flat; may wake up with difficulty breathing -Fatigue, becoming tired easily - Bronchitis -Palpitations -Swelling of feet or ankles
Complications mitral stenosis	Atrial fibrillation and atrial flutter -Blood clots to the brain (stroke), intestines, kidneys, or other areas -Heart failure -Pulmonary edema -Pulmonary hypertension
In the ECG for mitral stenosis	There is atrial fibrillation. No P waves are visible. The rhythm is irregularly irregular (random). With severe pulmonary hypertension, right ventricular hypertrophy can be seen.
Treatment for mitral stenosis	Cardiac Glycosides Diuretics -β-blockers -Ca2+ channel blockers -Anticoagulants -balloon valvotomy -surgical commissurotomy -valve replacement Digoxin
Negatively chronotropic Digoxin	slowing the heart rate by decreasing conduction of electrical impulses through the AV node, making it a commonly used antiarrhythmic agent in controlling the heart rate during atrial fibrillation or atrial flutter.
Positively inotropic digoxin	increasing the force of heart contraction via inhibition of the Na+/K+ ATPase pump.
Mitral regurgitation	long-term disorder in which the heart's mitral valve does not close properly, causing blood to flow backward (leak) into the upper heart chamber when the left lower heart chamber contracts. The condition is progressive, which means it gradually gets worse.
causes for mitral regurgitation	Mitral valve prolapse -Congenital -Atherosclerosis -Endocarditis -Heart tumors -High blood pressure -Marfan syndrome -Untreated syphilis
Symptoms for mitral regurgitation	Cough -Fatigue -Palpitations (related to atrial fibrillation) -Shortness of breath during activity and when lying down -Urination, excessive at night enlarged liver
Treatment	Antibiotics reduce the risk of infective endocarditis in patients with mitral valve prolapse who are having dental work. -Antihypertensive drugs and vasodilators. -Anticoagulant or antiplatelet medications prevent clot formation in patients with atrial fibrillation. - Digitalis may be used to strengthen the heartbeat, along with diuretics to remove excess fluid in the lungs.
Cerebral cardiac output percentage	15 percent
coronary cardiac output percentage	5 percent
renal cardiac output percentage	25%
Gastrointestinal cardiac output percentage	25 percent
skeletal cardiac output percentage	25 percent
skin cardiac output percentage	5 percent
Regulating of arterial Pressure fast mechanism	neural baroreceptor
Regulating of arterial Pressure slow mechanism	hormonal (renin-angiotensin-aldosterone)
Baroreceptor reflex is a _______ _______ _______ that is responsible for the minute-to-minute regulation of arterial pressure.	negative feedback system
Baroreceptors are stretch receptors located within the walls of the______ _____near the bifurcation of the common carotid arteries.	carotid sinus
four effects attempt to increase the arterial pressure to normal	Increases heart rate Increases contractility and stroke volume Increases vasoconstriction of arterioles Increases vasoconstriction of veins
Example of the baroreceptor reflex	response to acute blood loss
.Renin-angiotensin-aldosterone system	is a slow, hormonal mechanism and Regulation by adjustment of blood volume.
-Renin	is an enzyme.
Angiotensin I	is inactive.
Angiotensin II	is physiologically active and is degraded by angiotensinase.
Example : response of the RAA system	acute blood loss
Other regulation of arterial blood pressure	Cerebral ischemia Chemoreceptors in the carotid and aortic bodies Vasaopressin (antidiuretic hormone) Atrial natriuretic peptide (ANP
Cerebral ischemia	Pco2 pressure increases in brain tissue.b. Chemoreceptors in the vasomotor center respond by increasing sympathetic outflow to the heart and blood vessels.Constriction of arterioles causes intense peripheral vasoconstriction and increased TPR. Blood flow to other organs (kidneys) is significantly reduced in an attempt to preserve blood flow to the brain.
The Cushing reaction in an example of the response to	cerebral ischemia
Cushing reaction	Increases intracranial pressure cause compression of the cerebral blood vessels, leading to cerebral ischemia and increased cerebral Pco2. The vasomotor center directs an increase in sympathetic outflow to the heart and blood vessels, which causes a profound increase in arterial pressure.
Chemoreceptors in the carotid and aortic bodies are located near	the bifurcation of the common carotid arteries and along the aortic arch.
Chemoreceptors in the carotid and aortic bodies have very high rates of	O2 consumption and are very sensitive to decreases in the partial pressure of oxygen (Po2).
Decreases in Po2 activate vasomotor centers that produce	vasoconstriction, an increase in TPR, and an increase in arterial pressure.
Atrial Natriuretic peptide binds to a specific set of receptors. Receptor-agonist binding causes	causes a reduction in blood volume and therefore a reduction in cardiac output and systemic blood pressure.
Atrial Natriuretic peptide Inhibits	renin secretion, thereby inhibiting the renin-angiotensin system.
Atrial Natriuretic peptide Reduces_______ secretion by the adrenal cortex.	aldosterone
Atrial Natriuretic peptide Relaxes vascular smooth muscle in	arterioles and venules.
True capillaries do not have	smooth muscle; they consist of a single layer of endothelial cells surrounded by a basement membrane
Blood flow through the capillaries is regulated by __________ and _________of the arterioles and the precapillary sphincters.	contraction and relaxation
Clefts (pores) between the endothelial cells allow passage	of water-soluble substances. The clefts represent a very small fraction of the surface area
At the junction of the arterioles and capillaries is a smooth muscle	band called the precapillary sphincter.
Passage of substances across the capillary wall	Lipid-soluble substances (o2 and CO2) . Small water-soluble substance Large water-soluble substances
How do small water soluble substance cross the capillary wall	via the water-filled clefts between the endothelial cells.
In the liver and intestine, the clefts of the capillary wall are	exceptionally wide and allow passage of protein. These capillaries are called sinusoids.
how do large water soluble substances cross across the capillary wall	pinocytosis
Function of lymph	, filtration of fluid out of the capillaries is slightly greater than absorption of fluid into the capillaries. The excess filtered fluid is returned to the circulation via the lymph. Lymph also returns any filtered protein to the circulation.
Unidirectional flow of lymph	one-way flap valves permit interstitial to enter, but not leave, the lymph vessels. -Flow through larger lymphatic vessels is also unidirectional, and is aided by one-way valves and skeletal muscle contraction.
Edema	occurs when the volume of interstitial fluid exceeds the capacity of the lymphatic to return it to the circulation. -can be caused by excess filtration or blocked lymphatics.

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